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General NPI Number Information
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NPI Number | 1083769533
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Entity Type | Organization
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Legal Business Name | CITIZENS CHOICE PHYSIOCARE, INC.
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Dates
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Enumeration Date | 01/24/2007
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Last Update Date | 04/28/2025
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Provider Practice Location Address
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Address Line | 5865 RIDGEWAY CENTER PARKWAY SUITE 300
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City | MEMPHIS
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State | TN
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Zip | 38120
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Country | US
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Telephone | 901-650-6651
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Fax | 901-767-5544
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Provider Business Mailing Address
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Address Line | PO BOX 241454
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City | MEMPHIS
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State | TN
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Zip | 38124-1454
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Country | US
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Telephone | 901-650-6651
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Fax | 901-767-5544
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. CHANDRA L. BERRY
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Credential |
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Telephone | 901-650-6651
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | L000000013310
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | L000000013311
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 343800000X
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Taxonomy Name | Secured Medical Transport (VAN)
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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